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Review
. 2017 Sep;19(3):249-260.
doi: 10.5853/jos.2016.01956. Epub 2017 Sep 6.

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

Wen-Jie Yang  1 , Ka-Sing Wong  1 , Xiang-Yan Chen  1
Affiliations
Review

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

Wen-Jie Yang et al. J Stroke. 2017 Sep.

Abstract

Intracranial atherosclerosis is one of the leading causes of ischemic stroke and occurs more commonly in patients of Asian, African or Hispanic origin than in Caucasians. Although the histopathology of intracranial atherosclerotic disease resembles extracranial atherosclerosis, there are some notable differences in the onset and severity of atherosclerosis. Current understanding of intracranial atherosclerotic disease has been advanced by the high-resolution magnetic resonance imaging (HRMRI), a novel emerging imaging technique that can directly visualize the vessel wall pathology. However, the pathological validation of HRMRI signal characteristics remains a key step to depict the plaque components and vulnerability in intracranial atherosclerotic lesions. The purpose of this review is to describe the histological features of intracranial atherosclerosis and to state current evidences regarding the validation of MR vessel wall imaging with histopathology.

Keywords: Autopsy; Histology; Intracranial atherosclerosis; Magnetic resonance imaging.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1.
Figure 1.
Basic structure of intracranial and extracranial arteries. IEL, internal elastic lamina; EEL, external elastic lamina.
Figure 2.
Figure 2.
Large intracranial arterial segments with hematoxylin- eosin staining. (A) Middle cerebral artery. (B) Basilar artery. (C) Vertebral artery with vasa vasorum. Original magnification: 1.6×1.6.
Figure 3.
Figure 3.
Plaque components on histology. (A) Intraplaque hemorrhage. (B) Neovascularue (arrows). (C) Calcification (arrows). Original magnification: ×20.
Figure 4.
Figure 4.
Representative magnetic resonance (MR) images and the corresponding histology slides. (A, B) The hyper-intense on MR images (arrow in A) was verified to be intraplaque hemorrhage (arrow in B). (C, D) The hypo-intense on MR images (arrow in C) was verified to be lipid accumulation (arrow in D). The histological slides were stained with hematoxylin-eosin staining. Original magnification: ×1.6.
See this image and copyright information in PMC

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